Percutaneous Transluminal Coronary Angioplasty (PTCA)

What other terms are used to describe percutaneous transluminal angioplasty?

A PTCA is a procedure that opens narrowed arteries to increase blood flow.
A PTCA may be done instead of coronary artery bypass surgery depending
upon the type and location of the narrowing, the extent of the disease and the risk involved.
The rate of restenosis (renarrowing of the blood vessel) is 25 to 80 percent within the first six months.

This procedure is nonsurgical and is performed under X-ray guidance in the Cardiac Catheterization Laboratory.
A PTCA may be done immediately following a cardiac catheterization or sometime later.
You will be given a mild sedative to help you relax but you will remain awake during the procedure in order to answer questions regarding your comfort level, any chest pain or shortness of breath.
A small area of the groin is shaved and cleaned where the catheter will be inserted.
Medication will be used to anesthetize (numb) the area so a small incision can be made where the catheter will be inserted.
A catheter with a deflated balloon on the tip is inserted through the artery into the groin. Xray is used to guide the catheter up into the heart.
The catheter is threaded up into the narrowed artery of the heart. The balloon is then inflated and deflated several times to "squeeze" the plaque deposits against the wall of the artery.
The test takes 1 to 2 hours.

A slight burning or stinging from the medicine used to numb the catheter insertion site
Slight discomfort or pressure as the catheter is being inserted
Slight nausea and/or extra heart beats
Temporary chest pain may occur as the balloon catheter is being inflated, but it is temporary

After X-rays are taken, the balloon and catheter are removed, but the sheath (IV) will remain in place.
A sheath (IV) is usually left in place in the leg overnight until the blood thinning medications are discontinued and your clotting time has returned to normal.
A bandage or pressure dressing will be placed over the area where the catheter was inserted.
You will be admitted to a special cardiac care unit to be monitored closely.
When the sheath is removed from the groin, firm pressure is applied to the insertion site for 15 to 30 minutes until the bleeding stops.
The insertion site will be checked frequently for signs of bleeding.
Blood pressure and the pulse in the leg will be checked frequently.
A lump may occur under the skin where the catheter was inserted. This is only temporary.
Bruising may occur in the area of the leg/groin where the catheter was inserted and may spread down the leg. This is only temporary.
Most patients are discharged 4 to 6 hours after the sheath is removed with minimal activity restrictions.

Avoid bending the leg at the hip for 6 to 8 hours after the catheter is removed.
Hold your fingers over the puncture site firmly if you need to cough or sneeze.
Avoid heavy lifting, stairs and driving for at least 48 hours after you return home.

Discomfort or sudden pain at the insertion site
A warm, moist and sticky feeling or bleeding
Any discomfort in chest, neck, jaw, arms or upper back, shortness of breath, weakness or dizziness

You will continue to have routine follow-up visits with your cardiologist after this procedure.

Have nothing to eat or drink after midnight.
It is important to ask your doctor about:
- How to adjust insulin and food intake prior to the test if you are diabetic
- Wheather you should take your regular medications the day of the test
- If you are taking blood thinners (i.e. Coumadin), wheather they should be stopped and, if so, how long prior to the procedure
Leave all valuables at home.
Plan to be admitted to the hospital overnight.

Make arrangements for someone to drive you home.

For more information contact your healthcare provider or email cardiology@highlinemedical.org.